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WO1993021835A1 - Catheter a ultrasons d'elimination des obstructions de structures tubulaires anatomiques telles que des vaisseaux sanguins - Google Patents

Catheter a ultrasons d'elimination des obstructions de structures tubulaires anatomiques telles que des vaisseaux sanguins Download PDF

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Publication number
WO1993021835A1
WO1993021835A1 PCT/US1993/004207 US9304207W WO9321835A1 WO 1993021835 A1 WO1993021835 A1 WO 1993021835A1 US 9304207 W US9304207 W US 9304207W WO 9321835 A1 WO9321835 A1 WO 9321835A1
Authority
WO
WIPO (PCT)
Prior art keywords
proximal
transmission member
ultrasound transmission
ultrasound
catheter
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US1993/004207
Other languages
English (en)
Inventor
Henry Nita
Douglas H. Gesswein
James D. Passafaro
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Baxter International Inc
Original Assignee
Baxter International Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US07/878,795 external-priority patent/US5267954A/en
Application filed by Baxter International Inc filed Critical Baxter International Inc
Priority to CA002135047A priority Critical patent/CA2135047C/fr
Priority to DE69318015T priority patent/DE69318015T2/de
Priority to EP93911045A priority patent/EP0639953B1/fr
Priority to JP51959993A priority patent/JP3398871B2/ja
Publication of WO1993021835A1 publication Critical patent/WO1993021835A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A—HUMAN NECESSITIES
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    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
    • A—HUMAN NECESSITIES
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    • A61B2017/00831—Material properties
    • A61B2017/0084—Material properties low friction
    • A61B2017/00849—Material properties low friction with respect to tissue, e.g. hollow organs
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    • A—HUMAN NECESSITIES
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    • A61B17/22004—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22014—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
    • A61B2017/22015—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member
    • A61B2017/22018—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member segmented along its length
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    • A61B2017/22038—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with a guide wire
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    • A61B2017/22038—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A61B2017/22039—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with a guide wire eccentric
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    • A61B2017/22038—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A61B2017/22041—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with a guide wire outside the catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320072—Working tips with special features, e.g. extending parts
    • A61B2017/320073—Working tips with special features, e.g. extending parts probe
    • A—HUMAN NECESSITIES
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    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320088—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with acoustic insulation, e.g. elements for damping vibrations between horn and surrounding sheath
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • A—HUMAN NECESSITIES
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    • A61B2217/00—General characteristics of surgical instruments
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
    • A61F2002/3006—Properties of materials and coating materials
    • A61F2002/30092—Properties of materials and coating materials using shape memory or superelastic materials, e.g. nitinol
    • A—HUMAN NECESSITIES
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    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
    • A61F2210/0019—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at only one temperature whilst inside or touching the human body, e.g. constrained in a non-operative shape during surgery, another temperature only occurring before the operation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
    • A61F2210/0023—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply
    • A61F2210/0042—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol operated at different temperatures whilst inside or touching the human body, heated or cooled by external energy source or cold supply using a fluid, e.g. circulating
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M2025/0183—Rapid exchange or monorail catheters
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Definitions

  • the present invention pertains to medical equipment and more particularly an ultrasonic catheter for ablating obstructions within tubular anatomical structures such as blood vessels.
  • Ultrasound transmitting catheters have been utilized to successfully ablate various types of obstructions from blood vessels of humans and animals. Particular success has been observed in ablation of atherosclerotic plaque or thromboembolic obstructions from peripheral blood vessels such as the femoral arteries. Successful applications of ultrasonic energy to smaller blood vessels, such as the coronary arteries, necessitates the use of ultrasound transmitting catheters which are sufficiently small and flexible to permit transluminal advancement of such catheter through the tortuous vasculature of the aortic arch and coronary tree. Accordingly, the safety and efficacy of removing obstructions from coronary arteries by way of ultrasound is largely dependent upon the size and flexibility of the ultrasound transmitting catheter(s) employed.
  • an ultrasound catheter device comprising an elongate flexible catheter body having at least one lumen extending longitudinally therethrough.
  • An elongate ultrasound transmission member extends through the catheter body and is connected, at its distal end, to a distal head. The entire distal head, or a portion thereof, may protrude out of and beyond the distal end of the catheter body.
  • a ultrasound catheter having an elongate ultrasound transmissio member extending longitudinally therethrough, said ultrasoun transmission member being formed of one or more superelasti materials, such as certain superelastic metal alloys, which exhibi superelastic properties within the range of temperatures undergon by the ultrasound transmission member during operation of th device.
  • an ultrasound catheter having an elongate ultrasoun transmission member extending longitudinally therethrough, sai elongate ultrasound transmission member having a proximal portion of a first cross-sectional dimension or diameter and a distal portion of a second cross-sectional dimension or diameter less than said first cross-sectional dimension or diameter.
  • an ultrasound transmission catheter having an elongate ultrasound transmission member extending therethrough and a guidewire passage lumen extending longitudinally through the catheter to permit the catheter to be utilized in accordance with over-the-wire (OTW) insertion techniques.
  • OW over-the-wire
  • an ultrasound transmission catheter having an elongate ultrasound transmitting member extending longitudinally therethrough and a guidewire guide or member extending laterally outboard of the catheter in at least one position thereon.
  • Such guidewire guide or support member is provided with at least one guidewire passage aperture extending longitudinally therethrough to permit a guidewire to be passed therethrough, thereby permitting the ultrasound catheter to be utilized in accordance with monorail guidewire insertion techniques.
  • an ultrasound transmission catheter having an elongate ultrasound transmitting member extending longitudinally therethrough and a distal guidewire lumen extending longitudinally through only a distal portion of the catheter.
  • Such distal guidewire passage lumen comprises an elongate tube or passageway having a distal end and a proximal end. The distal end of the elongate tube or passageway opens through a distal end aperture and the proximal end of the elongate tube or passageway opens through a guidewire entry/re-entry aperture formed at a point in the sidewall of the catheter.
  • a guidewire may be proximally or distally advanced through said distal guidewire lumen within the distal portion of the catheter body while a remaining proximal portion of the guidewire resides outside of and next to the catheter body.
  • proximal end connector assemblies which operate to connec the proximal end of an ultrasound transmission catheter to a ultrasound transducer.
  • the proximal end connector assemblies o the present invention comprise generally tubular members having a least one longitudinal bore through which the ultrasoun transmission member of the catheter may extend and at least on connector apparatus for connecting the ultrasound transmissio member to an attendant ultrasound transducer.
  • the sonic connector comprises a compressible gripping ferrule whic may be tightened to grip and firmly hold the ultrasoun transmission member in place to provide a damping effect to preven undesirable transverse movement.
  • the soni connector comprises a plurality of compressible plugs which ar also tightened to grip and firmly hold the ultrasound transmissio member to achieve the required damping effect, as well as to secur the ultrasound transmission member to the sonic connector.
  • the sonic connector comprises both a plurality o compressible plugs and a gripping ferrule.
  • a polymeric coating may be applied to the variou connections between the ultrasound transmission member and th sonic connector, either in conjunction with the gripping ferrul and/or the compressible plugs or independent of the ferrule an plugs, to secure these connections.
  • the proximal end connector assemblies of the present inventio may be provided with one or more fluid infusion sidearms fo infusing coolant liquid or other fluid through the bore of th proximal connector and through a lumen of the catheter body.
  • a guidewire passage sidearm ma be positioned on the proximal connector assembly to permi insertion and/or extraction of a guidewire through the proximal connector assembly and through the body of the catheter.
  • One o more guidewire diverting members such as an angled tubular member, may be positioned within the proximal connector assembly to diver a proximally advancing guidewire out of a guidewire sidear positioned thereon.
  • an ultrasound catheter having an elongate ultrasoun transmission member extending longitudinally therethrough, said ultrasound transmission member having a friction-reducing coatin or outer jacket formed thereon.
  • Such friction reducing coating o outer jacket may comprise a layer of low friction polymeric material such as polytetrafluoroethylene (ptfe) (teflonTM Dupont, Inc. , Wilmington, Delaware) or polyethylene.
  • ptfe polytetrafluoroethylene
  • Such friction reducing coating or jacket may be disposed over the entire outer surface of the ultrasound transmission member or may be confined to a specific region or regions thereof.
  • Figure 1 is a perspective view of a first embodiment of a over-the-wire ultrasound catheter of the present invention.
  • Figure 2 is partial enlarged perspective view of the dista end of a first embodiment of an over-the-wire ultrasound cathete of the present invention.
  • Figure 2a is a partial cut-away perspective view of a ultrasound transmission member positionable in an ultrasoun catheter and having a friction reducing coating or jacket dispose thereon.
  • Figure 3 is a longitudinal sectional view through Line 3-3 o Figure 2.
  • Figure 4 is an enlarged perspective view of the distal portio of an embodiment of a monorail ultrasound catheter of the presen invention.
  • Figure 5 is a perspective view of the distal portion of a embodiment of an ultrasound catheter of the present inventio having a region of enlarged diameter and a partial guidewire lume running through a distal portion of the catheter body.
  • Figure 5a is a perspective view of the distal portion of a embodiment of an ultrasound catheter of the present inventio having a partial guidewire lumen running through a distal portio of the catheter body.
  • Figure 6 is a longitudinal sectional view of the embodiment o the ultrasound catheter shown in Figure 5.
  • Figure 6a is an exploded view of a distal tip of th " ultrasound catheter embodiments shown in Figures 5 and 5a.
  • Figure 6b is an enlarged view of the distal end of the longitudinal sectional view of Figure 6.
  • Figure 7 is a perspective view of a proximal end connector end apparatus positionable on the proximal end of an ultrasound catheter of the present invention for connecting the catheter to an ultrasound transducer.
  • Figure 8 is a perspective view of an alternative proximal end connector - assembly positionable on the proximal end of an ultrasound catheter having an internal guidewire lumen for attaching the ultrasound catheter to an ultrasound transducer.
  • Figure 9 is a longitudinal sectional view of the proximal end connector assembly shown in Figure 5.
  • Figure 10 is a perspective view of the guidewire diverter apparatus and a first embodiment of a sonic connector positioned within the proximal end connector assembly shown in Figures 5 and 6.
  • Figure 11 is an enlarged perspective view of a second embodiment of a sonic connector positioned within the proximal end connector assembly of Figure 10.
  • Figure 12 is a cross-sectional view of the sonic connector of Figure 11 taken along Line 12-12 in Figure 11.
  • Figure 13 is an enlarged perspective view of a third embodiment of a sonic connector positioned within the proximal end connector assembly of Figure 10.
  • Figure 14 is an enlarged perspective view of a fourth embodiment of a sonic connector positioned within the proximal en connector assembly of Figure 10.
  • Figure 15 is an enlarged perspective view of a fift embodiment of a sonic connector positioned within the proximal en connector assembly of Figure 10.
  • the ultrasound catheters of the present invention include bot "over-the-wire” configurations and “monorail” configuration.
  • the term “over-the-wire” shall refer to an ultrasoun catheter which has a guidewire passage lumen formed within the bod of the catheter such that a flexible guidewire may be advance through the body of the catheter and out of a guidewire passag aperture formed in the distal end of the catheter.
  • the term “monorail” shall refer to an ultrasound catheter which ha a guidewire supporting structure at or near the distal tip of th catheter and extending laterally outboard of the outer surface o the catheter body such that a flexible guidewire may reside next t the catheter body with the distal end of such guidewire extendin through and/or being held by the guidewire supporting structur formed on or near the distal end of the catheter body.
  • Figure l is a perspective showing of an over-the-wir ultrasound catheter 10 of the present invention having a proxima end connector assembly 12 mounted on the proximal end thereof.
  • a ultrasound transducer 14 is connected to the proximal end of th proximal connector assembly 12.
  • An ultrasound generator 16 havin a foot actuated on/off switch 18 is operatively connected to th ultrasound generator 14 so as to send ultrasonic energy through th ultrasound catheter 10, when desired.
  • an over-the-wire ultrasound catheter 10 o the present invention are-shown in Figures 2 and 3.
  • an over-the-wire ultrasound catheter 10 of th present invention comprises a flexible tubular catheter body 2 having a hollow lumen 22 extending longitudinally therethrough.
  • This over-the-wire catheter body preferably has an outside diamete of 0.5 mm - 5.0 mm.
  • catheters 10 intended for insertion int tortuous or relatively small anatomical structures e.g., th coronary arteries
  • a monorai ultrasound catheter 10a of the present invention comprises flexible tubular catheter body 20a having a hollow lumen 22 extending longitudinally therethrough.
  • the outside diameter of th catheter body 20a of the monorail catheter 10a be 0.5 mm - 5.0 mm.
  • monorail catheters 10a intended for use in tortuous o relatively small anatomical structures e.g.
  • the outer diameter of the cathet body be 0.25 mm - 2.0 mm and it is further specifically preferab that the width of the distal head 26a be, at its widest point, greater than 3.0 mm such that the entire distal head 26a and t catheter body 20a may be inserted into an anatomical passageway approximately 3.0 mm diameter, (e.g. the coronary artery).
  • an ultrasound transmission member 24 or wave gui extends longitudinally through the lumen 22 of the catheter body 2 to transmit ultrasonic energy from an ultrasound transducer connected to the proximal end of the catheter 10 to the distal e thereof.
  • a distal head 26 is mounted on the distal e of the ultrasound transmission member 24.
  • the distal head 26 comprises generally round, conical, o disc-shaped distal portion 28 and a reduced diameter neck o proximal portion 30.
  • the outer diameter OD of the proximal portio 30 of the distal head 26 is approximately the same as or slightl less than the inner diameter ID of the catheter lumen 22 such tha the proximal portion 30 of the distal head 26 may be inserted int the distal end of the lumen 22, to a point where the distal tip o the catheter body 20 abuts against the proximal aspect of th distal portion 28 of the distal head 26, as shown.
  • the ultrasound transmission member 24 may be formed of an material capable of effectively transmitting the ultrasonic energ from the ultrasound transducer 14 to the distal end of the cathete body 20, including but not necessary limited to metal, plastic hard rubber, ceramic and/or composites thereof.
  • all or portion of the ultrasound transmission member 24 may be formed o one or more materials which exhibit superelasticity.
  • Suc material(s) should preferably exhibit superelasticity consistentl within the range of temperatures normally encountered by th ultrasound transmission member 24 during operation of the devic 10.
  • all or part of the ultrasound transmissio member 24 may be formed of one or more metal alloys known as "shap memory alloys".
  • 4,665,906; 4,565,589; 4,505,767; and 4,337,090 are expressly incorporated herein by reference insofar as they describe the compositions properties, chemistries and behavior of specific metal alloys which are superelastic within the temperature range at which the ultrasound transmission member of the present invention operates, any and all of which superelastic metal alloys may be usable to form the superelastic ultrasound transmission member 24 of the present invention.
  • one presently preferred superelastic metal alloy of which the ultrasound transmission member 24 may be formed is a nickel-titanium alloy wire made up of 55.8 weight percen nickel (NiTi containing 55.8% weight % Ni balance Ti) .
  • the ultrasound transmissio member 24 may be tapered, narrowed or otherwise reduced in cross sectional dimension within a distal portion of the catheter so a to decrease the rigidity of the ultrasound transmission member 2 within such distal portion of the device and also to caus amplification of the ultrasound transmitted to the distal head 26 As shown in Figure 6, such tapering or narrowing of the ultrasoun transmission member divides the ultrasound transmission member int a proximal portion 24p and a distal portion 24d.
  • An angula tapered or narrowing region 154 embodies the transition zon between the larger proximal portion 24p and the smaller dista portion 24d.
  • the distal portion 24d of the ultrasoun transmission member is of smaller cross-sectional diameter and les mass, it is more flexible and less rigid than the proximal portio 24p thereof.
  • Such configuration of the ultrasound member 2 enables the relatively large sized proximal portion 24p to transmi more ultrasonic energy than if the entire length of the ultrasoun transmission member 24 were to be of the relatively small cross sectional size of the distal portion 24d thereof. Additionally such decrease in the cross-sectional size of the distal portion 24 of the ultrasound transmission member 24 results in a amplification of the ultrasound transmitted through such dista portion 24d thereof.
  • the proximal portion 24p of the ultrasound transmission member is rendered capable o transmitting a greater amount of ultrasonic energy to the distal end of the catheter than would otherwise be possible, while th reduced cross-sectional size of the distal portion of th ultrasound transmission member 24 additionally serves to amplif the ultrasound reaching the distal head 26 of the device.
  • the taper 154 of the ultrasound transmission member 24b be positioned at the distal end of the bulge or enlarged region 152 so as to result i that portion of the catheter lying distal to the distal end of the enlarged region 152 being more flexible and less rigid than the remainder of said catheter, due to the decreased diameter of the ultrasound transmission member 24d extending through such portion.
  • the tapered region 154 of the ultrasound transmission member 24 may be formed at any point desired such that portion of the catheter lying distal to the tapered region 154 will, as a result, exhibit less rigidity and greater flexibility than the remainder of the catheter body.
  • the present invention further includes an optional improvement to the ultrasound transmission member 24 of any ultrasound transmitting catheter, said improvement comprising the dispositio of a low friction coating or jacket 25 on the outer surface of al or a portion of the ultrasound transmission member 24.
  • the low friction coating or jacket 25 may be disposed o the outer surface of the ultrasound transmission member 24 so as t completely cover the ultrasound transmission member 24 along it entire length, or along a discrete region or regions thereof.
  • Suc coating or jacket 25 may comprise a layer of low friction polyme material such as polytetrafluoroethylene (ptfe) (teflonTM Dupont Inc., Wilmington, Delaware) or other plastic materials such a polyethylene.
  • the coating or jacket 25 may be applied as a liqui and subsequently allowed to cure or harden on the surface of th ultrasound transmission member 24.
  • the coatin jacket 25 may be in the form of an " elongate tube slideabl disposable over the outer surface of the ultrasound transmissio member 24.
  • Such coating or jacket 25 serves to prevent or diminis friction between the outer surface of the ultrasound transmissio member 24 and the adjacent structures of the catheter 10 o proximal end connector assembly 12 through which the ultrasoun transmission member 24 extends.
  • the distal head 26 is firmly bonded, attached, or connected t the catheter body 20 such that the distal head is prevented fro undergoing longitudinal or transverse movement separate from o relative to the catheter body.
  • Such non-moveable affixation of th distal head 26 to the catheter body prevents longitudinal o transverse movement of the distal head 26 apart from the cathete body 20.
  • affixation of the distal head to th catheter body increases the conveyance of ultrasound energy int the distal portion of the catheter body 20, thereby resulting i enhanced cavitation effects created by the distal portion of th catheter body.
  • Such bonding connection or attachment of the dista head 26 to the catheter body 20 may be accomplished by any suitabl means.
  • One means of attaching the distal head 26 to the cathete body 20 is through the use of adhesive 32.
  • the adhesive 32 is applied to the proximal portion 30 of the distal head 26 prior to insertion thereof into the distal end of the lumen 22 of the catheter body 20.
  • the adhesive 32 may comprise any suitabl adhesive, such as cyanoacrylate (eg. LoctiteTM, Loctite Corp., Ontario, CANADA, or Dron AlphaTM, Borden, Inc., Columbus, Ohio) or polyurethane (eg. DymaxTM, Dymax Engineering Adhesive, Torrington, CT.) to firmly bond and attach the distal head 26 to the catheter body 20.
  • the distal head 26 may be formed of any suitable rigid material such as metal or plastic. In devices wherein the distal head is formed of plastic, the surrounding plastic catheter body 20 may be thoroughly welded, heat sealed or solvent welded to the plastic distal head 26, in accordance with the types of plastics employed.
  • various mechanical or frictional connectors such as screw threads, lugs or other surface modifications formed on the proximal portion 30 of the distal head 26, may be utilized to hold the distal head 26 in a fixed position relative to the catheter body 20.
  • corresponding grooves, detents or surface modifications may also be formed in the surrounding inner wall of the catheter body 20 so as to cooperate with any such threads, lugs or other surface modifications formed on the opposing surface of the distal head 26.
  • Such threads, lugs or other surface modifications will be configured and constructed so as to mechanically or frictionally hold the distal head 26 in fixed position relative to the catheter body 20.
  • the distal head 26 is preferably formed of radiodense material so as to be easily discernable by radiographic means. Accordingly, the distal head 26 may preferably be formed of metal or, alternatively, may be formed of plastic, ceramic or rubber materials, optionally having one or more radiodense markers affixed thereto or formed therein.
  • the distal head 26 may be molded of plastic such as acrylonitrile-butadiene-styrene (ABS) and one or more metallic foil strips or other radio opaque markers may be affixed to such plastic distal head 26 in order to impart sufficient radiodensity to permit the distal head 26 to be readily located by radiographic means.
  • ABS acrylonitrile-butadiene-styrene
  • a quantity of radiodense filler such as powdered bismuth or BaS0 4 may be disposed within the plastic or other non-metallic material of which the distal head 26 is formed so as to impart enhanced radiodensity to the distal head 26.
  • An optional guidewire passage aperture 40 may extend * longitudinally through the distal head 26.
  • Such guidewire passage aperture 40 may be formed through the distal head at a location inboard of the catheter body 20 such that a guidewire 42 may be advanced through a lumen 22 of the catheter body and through guidewire passage aperture 40.
  • Such embodiments of the ultrasound catheter 10 wherein the guidewire 42 passes through a lumen formed within the catheter body 20 and out of the catheter passage aperture 40 constitute an "over-the-wire" embodiment of the invention.
  • the distal head 26a may be formed such that a portion of the distal head extends laterally outboard of the outer surface of the catheter body 20a and the guidewire passage aperture 40a may be, likewise, positioned outboard of the outer surface of the catheter body 20a thereby forming a guidewire alongside the catheter body 20a and through the guidewire passage aperture 40a.
  • Such embodiments of the invention wherein the guidewire 42a is passed outboard of the outer surface of the catheter body 20a and through the catheter passage aperture 40a are referred to sometimes herein as "monorail" embodiments.
  • the ultrasound catheter of the present invention may also be formed in embodiments which constitute combinations or hybrids of such over-the-wire and monorail embodiments, as shown in Figures 5, 5a and 6.
  • such embodiments of the invention comprise an ultrasound catheter having a guidewire passage lumen formed through a distal portion of the catheter body only, with a guidewir entry/re-entry aperture 160 being formed through a sidewall of th catheter to permit passage of the guidewire 42 from the dista guidewire lumen of the catheter to a position outside the cathete body.
  • the catheter body 20b may b provided with a distal guidewire passage tube 156 positioned withi the inner bore or lumen 22b of the catheter body 20b and extendin from a guidewire re-entry aperture 160 to the guidewire passag aperture 40b formed in the distal head 26b of the device.
  • a pre-inserted guidewire may be inserted int the distal end of the catheter body 20b through guidewire passag aperture 40b and subsequently advanced in a proximal directio through the guidewire lumen 158 to a point where the proximal en of the guidewire 42 emerges out of guidewire entry/re-entr aperture 160.
  • the proximal portion of the guidewire 42 may exten and/or reside adjacent the outer surface of the proximal portion o the catheter body 20b as shown.
  • the catheter body 20b and th guidewire 42 may then be distally and/or proximally repositioned relative to one another, during the procedure.
  • the guidewire 42 may be fully withdrawn and extracted by pullin the guidewire in a proximal direction such that the distal tip o the guidewire is pulled out of the guidewire entry/re-entr aperture 160 and the guidewire 42 is subsequently fully withdraw out of the body, leaving only the ultrasound catheter in place.
  • distal head 26 is shown in the embodiments of Figures 5, 5a, 6, 6a and 6b.
  • the distal head 26b, 26c is secured to the distal end of the catheter body 20b, 20c by way of an annular ring member 150 and a quantity of adhesive ADH.
  • this embodiment of the distal head 26b comprises a distal portion 28b and a reduced diameter proximal portion 30b which is insertable into the distal end of the lumen 22b of the catheter body 20b.
  • the distal portion 28b of the distal head- 26b has a grooved detent or annular shoulder 148 formed therein.
  • the proximal portion 3Ob of the distal head 26b is inserted into the distal end of the lumen 20b of the catheter body and may be secured thereto by way of a quantity of adhesive.
  • An annular ring member 150 is then passed in a proximal direction over the catheter body 20b and advanced to a point where the annular ring member 150 abuts against shoulder 148.
  • a quantity of adhesive ADH is then applied to secure the annular ring member 150 around the distal tip of the catheter body 20b and the part of the distal portion 28b of the distal head 26b.
  • the adhesive ADH may be tapered or smoothed to form a constant angular transition from the distal portion 28b of the distal head 26b to the outer surface of the catheter body 20b as shown.
  • the distal head 26b and annular ring member 150 may be formed of any suitable rigid material such as metal or plastic. In embodiments where metal materials are employed, metal bonding or metal welding may be utilized as an alternative to or in addition to the use of adhesives for bonding the assembly to the distal end of th catheter body 20b. In embodiments wherein the distal head 26b an annular ring member 150 are formed of plastic, thermal welding, heat fusing or solvent welding techniques may be used as a alternative or in addition to the use of adhesives for suc purpose.
  • the outer diameter of the annular ring membe 150 be approximately the same as the largest outer diameter of th extreme distal portion 28b of the distal head 26b such that smooth- transition is formed from the distal head 26b to the oute surface of the catheter body 20b.
  • one or more fluid outflow aperture(s) 50 are formed at or near the distal end of the catheter body 20 to permit fluid to flow out of a lumen 22 of the catheter 10.
  • the provision of such fluid outflow aperture(s) 50 near the distal end of the catheter 10 facilitates continual or intermittent passage of coolant liquid into the proximal end of the lumen 22, distally through the lumen 22, and out of fluid outflow aperture(s) 50.
  • the lumen 22 of the catheter 10 into which the fluid outflow aperture(s) communicates will be the same lumen wherein the ultrasound transmission member 24 is located such that coolant liquid may be infused into the proximal end of such lumen 22, distally therethrough and out of fluid outflow aperture(s) 50 in a manner that will bathe and cool the body of the ultrasound transmission member 24, thereby preventing the ultrasound transmission member 24 from overheating during use.
  • one or more fluid outflow aperture(s) 51 may be formed through the distal head 26 to permit fluid to flow directly out of the distal end of the catheter 10.
  • a guidewire aperture 40 formed through the distal head 26 such guidewire aperture may be slightly larger than the outer diameter of the guidewire 42 to be passed therethrough so as to permit fluid to be infused through the guidewire lumen and to pass out of the guidewire aperture 40, even when a guidewire 42 is extending therethrough.
  • the guidewire aperture 40 may, in some embodiments, preclude the necessity for and/or perform the function of a separate dedicated fluid outflow aperture 51 extending through the distal head 26.
  • one or more separate lumens having separate outflow apertures formed at or near the distal tip of the catheter may be formed for infusion of oxygenated perfusate, medicaments or other fluids into the blood vessel or other anatomical structure in which the catheter is positioned.
  • proximal end connector apparatus 12 may be positioned on the proximal end of the catheter body to facilitate operative connection of the ultrasound transmission member 24 to an ultrasound transducer 14 and ultrasound generation device 16. Examples of embodiments of such proximal end connector apparatus 12 are shown in Figures 7-10.
  • Figure 7 shows a relatively simple proximal end connector apparatus 12a configured for use in connection with catheters which do not incorporat internal guidewire passage lumens.
  • Figure 8 shows a more comple proximal end connector 12b configured for use in connection wit catheters having internal guidewire passage lumens.
  • the embodiment of the proximal end connector 12a shown i Figure 7 comprises a rear portion 92 and a mid-portion 90.
  • gripping member 96 formed on the proximal end of the mid-portion 9 operates to attach the proximal end connector 12a to the proxima end of the catheter 20.
  • the mid-portion 90 comprises an elongat tubular body 80 having a tubular fluid infusion sidearm 8 extending outwardly therefrom to permit infusion of coolant flui or other liquid into the inner lumen 81 of the proximal en connector 12a.
  • the more complex embodiment of the proximal end connector 12 shown in Figure 8 comprises the same rear portion 92 and mid portion 90 as the simpler embodiment 12a shown in Figure 7.
  • the more complex embodiment 12b of Figure 8 furthe comprises a frontal portion 88 which is configured and constructe to facilitate insertion and/or extraction of a guidewire 42 throug a lumen or passageway formed internally within the catheter 20.
  • the proximal end connecto apparatus 12 comprises an elongate rigid body 80 having a hollo bore 81 extending longitudinally therethrough.
  • the elongate body of the proximal end connector 12 i actually constructed of a frontal portion 88, a mid-portion 90 an a rear portion 92.
  • the frontal portion 88 of the elongate body 8 is firmly connected to the proximal end of the catheter body 20 by way of a threaded gripping member 94.
  • a sleeve 21 having an annular flange 23 formed on the proximal end thereof is positione on the proximal end of the catheter body 20 to engage grippin member 94 as shown.
  • the proximal end of the frontal portion 88 is connected to the distal end of the mid-portion 90 of the elongate body 80 by way of a second gripping member 96. Accordingly, to facilitate such construction, threads 98, 100 are formed on the opposite ends of the frontal portion 88 of the elongate body 80. Threads 102 are also formed on the proximal end of the mid- portion 90 of the elongate body 80 such that the mid-portion 90 may be threadably mounted within a correspondingly threaded bore formed in the distal end of the rear portion 92 of the elongate body 80.
  • An O-ring 104 is positioned at the bottom of the threaded bore formed in the distal end of the rear portion 92 such that, when the rear portion 92 is tightened over the threads 102 of the mid- portion 90, the proximal end 108 of the mid-portion 90 will abut against and compress O-ring 104 against ledge 105, thereby causing O-ring 104 to exert inward pressure against tube 110.
  • Tube 110 extends longitudinally through the hollow bore 81 within the rear portion 92 of the proximal connector apparatus 12.
  • the ultrasound transmission member 24 or wave guide extends longitudinally through the entire catheter body 20 and through the proximal end connector 12. The ultrasound transmission member 24 or wave guide is inserted into and engaged by threaded proximal connector 112.
  • Threaded proximal connector 112 is positioned within a cylindrical • recess 114 formed in the proximal end of the proximal connector apparatus 12.
  • a suitable ultrasound transducer 14 may be screwed onto and threadably connected to the threaded proximal connector 112 to accomplish passage of ultrasonic energy through the ultrasound transmission member 24 in a distal direction to the distal head 26 of the device.
  • the extreme proximal end of the proximal connector 12 is provided with a sonic connector assembly or apparatus configured to effect operative attachment of the proximal end of the ultrasound transmission member 24 to the horn of an ultrasound transducer 14.
  • the sonic connector assembly or apparatus is preferably configured and constructed to permit passage of ultrasound energy through the ultrasound transmission member or wave guide 24 with minimal lateral side-to-side movement of the ultrasound transmission member 24 while, at the same time, permitting unrestricted longitudinal forward/backward vibration or movement of the ultrasound transmission member 24.
  • a distal portion of the body of the threaded proximal connector 112 is configured to receive therein a compressible gripping ferrule 116.
  • Compressible gripping ferrule 116 has a small central aperture formed therethrough through which the ultrasound transmission member 24 passes, as shown.
  • a frontal member 118 is threadably tightened within the frontal portion of the body of proximal connector member 112 so as to compress gripping ferrule 116, thereby causing gripping ferrule 116 to firmly grip and hold the ultrasound transmission member 24 in place within the body of the proximal connector member 112.
  • the proximal connector member 112 may then be compressed or crimped inwardly so as to be additionally crimp connected or crimp fit to the proximal end of the ultrasound transmission member 24, thereby providing further gripping and attachment of the sonic connector assembly to the proximal end of the ultrasound transmission member.
  • a series of threads are formed on the outer surface of the proximal connector member 112 to permit the distal end of an ultrasound transducer horn to be threadably screwed onto and releasably attached to the sonic connector assembly.
  • the frontal member 118, gripping ferrule 116, and proximal connector member 112 combine to form a sonic connector assembly to which the horn of an ultrasound transducer may be attached and through which the ultrasonic energy may be transmitted into the ultrasound transmission member, with the gripping ferrule 116 acting to dampen transverse movement of the ultrasound transmission member 24.
  • a frontal member 218 is positionable on the ultrasound transmission.
  • ember 24 has a stem 220 with threads 222 provided thereon for threadable engagement with threads 221 provided in an opening of a proximal connector 212.
  • a plurality of compressible plugs 224 are configured to fit within the opening of the proximal connector 212 perpendicular to the axis of the ultrasound transmission member 24. In the preferred embodiment, four compressible plugs 224 are provided, but it will be appreciated by those skilled in the art that any number of compressible plugs 224 may be distributed about the circumference of the ultrasound transmission member 24.
  • the proximal connector 212 is also positionable on the ultrasound transmission member 24 and also has a stem 214 with threads 216 provided thereon for threadable engagement with threads 217 provided on a cavity 226 of a horn 228 of the ultrasound transducer 14. Again, a plurality of compressible plugs 224 are configured to fit within the cavity 226 of the ultrasound transducer horn 228 perpendicular to the axis of the ultrasound transmission member 24. The proximal-most end of the ultrasound transmission member 24 terminates at the promixal- most end of the stem 214 within the cavity 226.
  • the stem 214 and the ultrasound transmission member 24 may be crimped as shown at 230 to provide a more stable connection between the sonic connector assembly and the ultrasound transmission member 24.
  • the frontal member 218 and the proximal connector 212 are preferably made from stainless steel.
  • the compressible plugs 224 are preferably disposed along the threads 216, 217, 221 and 222 so that when the frontal member 218 is threadably screwed onto the proximal connector 212 and the proximal connector 212 is in turn threadably screwed onto the ultrasound transducer horn 228, the threads 216, 217, 221 and 222 exert an inward force against the plugs 224 provided thereat, thereby forcing the plugs 224 against the ultrasound transmission member 24 to provide a firm grip to minimize transverse movement of the ultrasound transmission member 2 ⁇ 4.
  • the compressible plugs 224 are preferably made from any compliant material such as plastic, nylon, teflon, ABS, polypropylene, polyolefins, natural and synthetic rubbers and ethylene vinyl acetate (EVA) .
  • the compliance of the plugs 224 also secures the threaded connection between the frontal member 218 and the proximal connector 212 so that this connection does not become loosened, which would otherwise cause the ultrasound transmission member 24 to become disengaged.
  • the plugs 224 may be provided at the threads 221 and 222 only, or at the threads 216 and 217 only, at both sets of threads 216 and 217 and 221 and 222, or elsewhere along the stems 214 and 220.
  • a gripping ferrule 116 is positioned between the threaded connection between the frontal member 218 and the proximal connector 212.
  • a plurality of compressible plugs 224 are positioned between the threaded connection between the proximal connector 212 and the transducer horn 228.
  • the embodiment of Figure 13 utilizes both the gripping ferrule and the compressible plugs to achieve the damping of transverse movement by the ultrasound transmission member 24, and to secure the ultrasound transmission member 24 to the sonic connector.
  • a polymeric coating may be applied to the threads 216, 217, 221 and 222.
  • the coating creates friction which functions to secure the threaded connections and prevent the threaded connections from becoming loose.
  • This polymeric coating may be made by PVC dispersions using a solvent release approach, or by thermal application of various thermoplastics such a polyethelene, EVA, and nylon, among others. It will be appreciate by those skilled in the art that the polymeric coating may b applied independent of the compressible plugs 224, or i conjunction with the compressible plugs 224.
  • the polymeric coatin may also be applied to the threaded regions of the first embodimen of the sonic connector assembly described in connection with Figur 10.
  • the polymeric coating may also be applie between the threaded connection between the proximal connector 21 and the transducer horn 228, with compressible plugs 224 or gripping ferrule 116 provided between the threaded connectio between the frontal member 218 and the proximal connector 212.
  • the embodiment of Figure 14 has a polymeric coating 25 provided between the transducer horn 228 and the proximal connecto 212, with compressible plugs 224 provided between the fronta member 218 and the proximal connector 212.
  • th embodiment of Figure 15 has a polymeric coating 250 provide between the transducer horn 228 and the proximal connector 212 with a gripping ferrule 116 provided between the frontal member 21 and the proximal connector 212.
  • the elongate tube 110 which extends through the rear portio 92 of the proximal connector apparatus 12 is specifically size such" that the lumen 120 of the tube 110 is large enough to permi the ultrasound transmission member 142 to pass therethrough with small amount of space remaining between the outer surface of th ultrasound transmission member 24 and the inner luminal surface o the tube 110.
  • a fluid inlet sidearm 82 is formed on the rigid body 80 of th proximal end connector apparatus 12.
  • Such fluid inlet sidearm 8 has a hollow bore 122 which extends therethrough and is in flui communication with the longitudinal bore 81 of.the proximal en connector 12.
  • pressurized fluid such as a coolant liquid
  • a coolant liquid may be specifically controlled to maintain th temperature of the ultrasound transmission member 24 at a desire temperature within its optimal working range.
  • the ultrasound transmissio member 24 is formed of a metal alloy which exhibits optimal physical properties (e.g.
  • the temperature and flow rate of coolant liquid infused through fluid infusion sidearm 82 may be specificall controlled to maintain the temperature of the ultrasound transmission member within the range of temperatures at which it demonstrates its most desirable physical properties.
  • the ultrasound transmission member 24 is formed of a shape memory alloy which exhibits super elasticity when in its martensite state, but which loses super elasticity as it transitions to an austenite state
  • the temperature at which such shape memory alloys transition fro a martensite state to an austenite state is known as th "martensite transition temperature" (M s ) of the material.
  • the fluid infused through sidearm 82 will be a such temperature, and will be infused at such rate, as to maintai the shape memory alloy of the ultrasound transmission member 2 below its martensite transition temperature (M s ) .
  • a guidewire insertion sidearm 84 may also be formed on th elongate body 80 of the proximal end connector apparatus 12.
  • Suc guidewire passage sidearm 84 has a hollow lumen 130 extendin therethrough and communicating with the longitudinal bore 81 of th proximal end connector 12.
  • a guidewire gripping/sealing apparatu 132 may be mounted on guidewire passage sidearm 84 to grasp an hold the guidewire 42 in fixed longitudinal position relative t the catheter 10 and to provide a seal to prevent backflow of bloo through the catheter 10. Examples of guidewire gripping/sealin apparatus 132 which may be utilized in this application included those which are which are available commercially as Product Nos.
  • Such commercially available guidewir gripping/valving apparatus 132 may be modified by inserting segment of plastic tubing 134 into the bore of such device t permit such device 132 to grip and seal against a guidewire 4 which is smaller in diameter than the existing diameter of the sea provided in such commercially available MDI sealing/valvin apparatus 132.
  • Other sealing/valving apparatus may also b employed.
  • an angle guidewire diverter tube 140 is positioned within the bore 130 o the guidewire passage sidearm 84 and a portion of the longitudina bore 81 of the body 80 of.the proximal end connector apparatus 12
  • Such guidewire diverter tube 140 comprises an obtuse angular ben B having an aperture 142 formed at the outer apex of such angula bend B.
  • the aperture 142 is sufficiently large to permit th ultrasound transmission member 24 to pass longitudinall therethrough without damping or interference from the body of th tube 140.
  • the aperture 142 is sufficiently large to allo irrigation/coolant liquid to flow therethrough when the ultrasoun transmission member 24 is positioned within the aperture 142.
  • the guidewire diverter tube 1 0 is configured and constructe such that, as the proximal end of guidewire 42 is advanced in proximal direction through the longitudinal bore 81 of the elongat body 80 of the proximal end connector 12, it will impinge agains the wall of guidewire diverter tube 140 and will thus be diverte outwardly through the guidewire passage sidearm 84.

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Abstract

Un cathéter à ultrasons (10) permet d'éliminer les obstructions se trouvant dans des structures tubulaires anatomiques telles que des vaisseaux sanguins, ce cathéter comprenant un corps flexible allongé (20) ayant un organe ou fil de transmission d'ultrasons (24) s'étendant longitudinalement à travers le corps du cathéter. Une tête distale (26) est formée sur l'extrémité distale de l'organe ou fil de transmission d'ultrasons (24) et est fixée au corps (20) du cathéter. L'organe ou le fil de transmission d'ultrasons peut être constitué avec n'importe quel matériau capable de transmettre une énergie ultrasonique, y compris des alliages métalliques superélastiques tels que les alliages métalliques de nickel titane. La partie distale de l'organe ou fil de transmission d'ultrasons (24) peut avoir un diamètre réduit afin d'améliorer la flexibilité et/ou l'amplification de l'énergie ultrasonique à travers la partie distale de l'organe ou fil de transmission d'ultrasons. Un connecteur d'extrémité proximale (12) peut être pourvu d'un connecteur sonique afin de coupler de manière efficace le cathéter (10) au transducteur d'ultrasons.
PCT/US1993/004207 1992-05-05 1993-05-04 Catheter a ultrasons d'elimination des obstructions de structures tubulaires anatomiques telles que des vaisseaux sanguins Ceased WO1993021835A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
CA002135047A CA2135047C (fr) 1992-05-05 1993-05-04 Sonde productrice d'ultrasons pour supprimer des obstacles dans des structures anatomiques en tube tels que les vaisseaux sanguins
DE69318015T DE69318015T2 (de) 1992-05-05 1993-05-04 Ultraschallkatheter zur beseitigung von obstruktionen aus rohrförmigen anatomischen strukturen, wie blutgefässen
EP93911045A EP0639953B1 (fr) 1992-05-05 1993-05-04 Catheter a ultrasons d'elimination des obstructions de structures tubulaires anatomiques telles que des vaisseaux sanguins
JP51959993A JP3398871B2 (ja) 1992-05-05 1993-05-04 血管等の解剖学的管状構造体から障害物を除去するための超音波カテーテル

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US07/878,795 1992-05-05
US07/878,795 US5267954A (en) 1991-01-11 1992-05-05 Ultra-sound catheter for removing obstructions from tubular anatomical structures such as blood vessels
US07/911,546 1992-07-09
US07/911,546 US5312328A (en) 1991-01-11 1992-07-09 Ultra-sound catheter for removing obstructions from tubular anatomical structures such as blood vessels

Publications (1)

Publication Number Publication Date
WO1993021835A1 true WO1993021835A1 (fr) 1993-11-11

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PCT/US1993/004207 Ceased WO1993021835A1 (fr) 1992-05-05 1993-05-04 Catheter a ultrasons d'elimination des obstructions de structures tubulaires anatomiques telles que des vaisseaux sanguins

Country Status (6)

Country Link
US (1) US5312328A (fr)
EP (1) EP0639953B1 (fr)
JP (1) JP3398871B2 (fr)
CA (1) CA2135047C (fr)
DE (3) DE69318015T2 (fr)
WO (1) WO1993021835A1 (fr)

Cited By (9)

* Cited by examiner, † Cited by third party
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US5733299A (en) * 1994-10-20 1998-03-31 Cordis Corporation Two balloon catheter
US5632760A (en) * 1994-10-20 1997-05-27 Cordis Corporation Balloon catheter for stent implantation
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US5846246A (en) * 1994-10-21 1998-12-08 Cordis Corporation Dual-balloon rapid-exchange stent delivery catheter with guidewire channel
EP0813389A4 (fr) * 1995-03-08 1998-05-06 Richard J Mackool Procede et appareil ameliores pour diminuer la friction et la production de chaleur par un dispositif de chirurgie utilisant les ultrasons
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US6482218B1 (en) 1996-04-26 2002-11-19 Khanh Vien Tran Wire-shaped ultrasonic catheter with diamond coated head for ultrasonic angioplasty
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DE69327351D1 (de) 2000-01-20
DE69318015T2 (de) 1998-12-24
JP3398871B2 (ja) 2003-04-21
EP0639953A1 (fr) 1995-03-01
DE69329432D1 (de) 2000-10-19
DE69318015D1 (de) 1998-05-20
US5312328A (en) 1994-05-17
CA2135047A1 (fr) 1993-11-11
DE69329432T2 (de) 2001-01-18
DE69327351T2 (de) 2000-05-04
CA2135047C (fr) 2001-10-02
JPH07506284A (ja) 1995-07-13
EP0639953B1 (fr) 1998-04-15

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